Appeal for new antibiotics after resistant E.coli infections treble

An increase in infections that are resistant to all known antibiotics is threatening Britain and the world, unless ways can be found to develop and finance new drugs, public health experts warned yesterday.

Fears have been heightened by a three-fold rise in resistant strains of E.coli, one of the hardest-to-treat infections, which can cause serious illness and death.

The Health Protection Agency said yesterday that of 20,000 blood stream infections caused by E.coli in an average year, the proportion that were resistant to antibiotics rose from 4 per cent in 2000 (800 cases) to 12 per cent in 2006, but that there were no new drugs being developed, or in the pipeline, to tackle them.

E.coli is the commonest cause of lethal blood stream infections, especially in old or sick people. It is a gram-negative bacterium, which is more difficult to treat than a gram-positive bacteria, such as MRSA, because it has a tougher cell wall.

David Livermore, an expert in antibiotic resistance at the HPA, said: "Since the late 90s there has been a big increase in resistance to major first line antibiotics [in gram-negative bacteria]. There is a long list of new antibiotics for gram-positive bacteria, such as MRSA but there is only one for gram-negative."

Doctors are being forced to use more powerful second line drugs, called carbapenems, the last line of antibiotic defence, to treat gram-negative infections, but resistance is emerging to them, too. An enzyme called KPC is destroying carbapenems "on a significant scale" in the US and Israel, and four cases have been recorded in the UK.

Dr Livermore said existing antibiotics were a "precious resource" that must be preserved against the development of resistance by sensible prescribing, but that alone would not be enough to protect patients.

"It remains critical that new antibiotics are developed. It is vital that the pharmaceutical industry remains interested in this area from a public health point of view," he said.

However, Dr Livermore said that drugs for chronic conditions such as heart disease, which a patient would take for years, were seen as more lucrative than antibiotics, which might be taken for just a few weeks.

"Antibiotic development, whether state or privately funded, has to be financially attractive and financially viable," he added.

Efforts should also be made to reduce the huge cost of bringing a new drug to market, which is estimated at £500m to £1bn, he said. Dr Livermore called for a "careful review" of the requirements governing clinical trials to "better tailor" them to meet the needs of prescribing physicians.

A spokesman for the Association of the British Pharmaceutical Industry (ABPI) said: "We have responded to the call for new treatments for gram-positive bacteria such as MRSA, and we are responding to the call for new options to combat gram-negative strains."